How Emotions Shape Our Mental Health & What We Can Do About It

Written by Eric Rangel Oliveira, AMHSW
Estimated Reading Time: 15 minutes

 

Many of us grow up without being taught how to handle our emotions, especially the painful or overwhelming ones. For people like Bob, whose early life was shaped by trauma, stigma, and emotional invalidation, these struggles can reverberate well into adulthood. This blog post explores the deep connection between emotional regulation and mental health by following Bob’s journey with anxiety and healing. Drawing on personal experience and psychological research, we will examine how our early environments shape our emotional habits, why certain strategies, such as suppression, backfire, and how therapy can help us develop more adaptive ways to cope. Whether you have been labelled with a mental health disorder diagnosis, like Generalised Anxiety Disorder, or feel at the mercy of your emotions, Bob’s story offers a powerful reminder: your feelings are not flaws, they are signals. Furthermore, learning to understand them is the first step toward healing.

What if the emotions we feel aren’t fixed reactions but something our brain creates based on past experiences, body sensations, and cultural learning? In this Emotional Regulation Blog Series, we will follow Bob (He/Him), a fictional yet deeply relatable character, on his journey from emotional numbness, withdrawal and anger outbursts to deeper connection and emotional mastery. Bob’s story was inspired by fragments of my own story and the stories of many friends, acquaintances and fictional characters I heard throughout my lifetime. His story may also resonate with the personal stories of so many readers of this blog post.

Bob, a gay man now in his late 40s, grew up in regional Australia in the 1980s and 90s, under values of silence, stigma, and stoicism. Bullying at school, emotional neglect at home, and high parental expectations and complex developmental trauma set the stage for a lifetime of emotional difficulties for him. Bob’s life story is not unusual, but it reveals profound lessons about how emotions are shaped, how they shape us and how they can be transformed.

Why do I like telling fictional stories?

I believe that the most powerful learning happens when ideas not only make sense in our heads but also resonate in our hearts. That is why, instead of listing dry definitions or statistics, I have chosen to illustrate these concepts through the story of a fictional character. Stories help us connect, remember, and reflect, and they often capture the real-world complexity of mental health in ways facts alone cannot.

As this story unfolds, we will understand how emotions and mental health are interconnected.

Why You Should Read This Story and What You Will Gain

Bob’s story is more than just a fictional case; it is a mirror reflecting the emotional patterns many of us fall into without even realising it. Whether you live with anxiety, have a loved one who struggles with their mental health, or want to better understand your emotional life, this story offers more than just information; it offers insight, empathy, and tools for change.

Here is what you will gain by reading it:

• A deeper understanding of how emotions and mental health are interconnected, based on research.
• Practical takeaways: You will learn about emotion regulation strategies, such as suppression, reappraisal, and acceptance, and how they can either exacerbate or alleviate anxiety and stress in everyday life.
• Validation of your emotional experiences: If you have ever felt overwhelmed by your feelings or judged yourself for having them, Bob’s journey will show you that you are not alone and that change is possible.
• You will be invited to reflect on your emotional patterns, beliefs, and coping strategies, and consider how you might approach them differently.

In a world that often encourages us to “stay strong” by shutting down our emotions, Bob’s story reminds us that real strength lies in embracing our emotions with curiosity and compassion.

Reader Disclaimer

This story explores themes that may be distressing or upsetting to certain individuals. While it is fictional and educational, it may still evoke strong or unexpected emotions in some readers. If you find yourself feeling overwhelmed, distressed, or triggered at any point, please prioritise your wellbeing. You may want to pause reading, speak with a trusted support person, or reach out to a qualified mental health professional for additional support.

If you are in Australia, you can contact:

• Emergency: 000
• Lifeline Australia: 131114 https://www.lifeline.org.au
• 1800RESPECT: 1800 737 732, https://www.1800respect.org.au
• Beyond Blue: 1300 224 636, https://www.beyondblue.org.au
• Kids Helpline: 1800-551-800, https://kidshelpline.com.au
• LGBTQ+ Crisis Hotline: 1800-184-527, https://qlife.org.au
• MensLine Australia: 1300-789-978, https://mensline.org.au
• National Alcohol & Other Drugs Hotline: 1800-250-015, https://www.health.gov.au/our-work/drug-help
• Suicide Call Back Service: 1300-659-467, https://www.suicidecallbackservice.org.au

Your emotional safety matters. This blog is here to educate, empower, and support, not replace professional care.

Bob’s Background 

Having grown up in regional Australia, during the 1980s and 90s, as a gay male in a conservative community, and having been relentlessly bullied at school and raised in a family environment where he was exposed to constant criticism and oscillatory pattern of nurture and care and physical and psychological abuse from his mother, Bob was always a bit on edge.

Even as a child, he noticed that his heart would race at school presentations or when meeting new people. Now in his 40s, he sat in his therapist’s office, anxious, exhausted, and confused. Bob had just been diagnosed with Generalised Anxiety Disorder (GAD) and was grappling with whether this label truly explained his daily struggle.

At work, as an award-winning Chef in a restaurant, Bob constantly worried about mistakes and tried to always be in control of what was happening as a way to reassure himself that things were done properly 100% of the time. After hours, he would spend his evenings ruminating on things he had said or done, or failed to say or do, during the day. He often felt overwhelmed by intense emotions that left him drained and ashamed.  So often, he had tried to “push his feelings down” to avoid appearing weak to others. However, this only made him feel worse and often led to explosive outbursts of anger. The harder he tried to control his emotions, the more they seemed to control him.

How Emotions and Mental Illness Interconnect

Bob’s story is not unusual. Many of us are taught early in life to suppress uncomfortable feelings or to avoid situations that might make us feel exposed. However, as we now understand from research, these instinctive reactions can have unintended consequences. Emotion regulation, how we respond to our emotional experiences, is central to our mental health. When we struggle regulating our emotions, this can contribute directly to the development and persistence of conditions like anxiety, depression, and trauma-related disorders (Gross, 2014).

Barlow (2002) proposed a “triple vulnerability” framework that helps us understand Bob’s experience. According to this model, anxiety disorders arise from (1) a biological vulnerability to heightened emotional reactivity, (2) a general psychological vulnerability such as believing the world is unpredictable or uncontrollable, and (3) specific learning experiences, such as traumatic events and repeated rejection, that, for instance, focus Bob’s anxiety on particular triggers. Bob’s upbringing taught him that emotions were risky and unsafe to express. Over time, this led to the development of automatic patterns of worry and avoidance.

Reflective Questions

• Have you noticed patterns in your family or upbringing that might contribute to how you handle stress or anxiety?
• Do certain situations or thoughts consistently trigger feelings of panic, dread, or avoidance for you?
• How might understanding your own “vulnerabilities” help you build healthier coping methods?

What Makes Emotion Regulation Difficult for People Like Bob?

The answer is not simple. Considering the work of Campbell-Sills et al. (2006), Bob’s struggles were shaped by multiple factors that also appear in the clinical literature. First, his emotional sensitivity meant he experienced emotions more intensely than others. Second, his negative emotions about his own emotions, what some call meta-emotions, triggered him to judge himself harshly for having those feelings. Third, his habitual strategy of suppression made things worse, increasing his distress and reducing his capacity to bounce back.

Neuroscience research backs this up. People with anxiety disorders often show reduced activation in the prefrontal cortex during efforts to regulate emotions and increased activation in emotion-generating areas like the amygdala (Goldin, Manber-Ball, et al., 2009; Ball et al., 2012). This means that anxious individuals are biologically wired to react more strongly and have more difficulty using cognitive control to regulate those responses.

Why Suppression Does not Work and What Does Work

Emotion regulation plays a critical role in the development and maintenance of anxiety disorders. Individuals with anxiety disorders often engage in maladaptive regulation strategies, particularly emotional suppression (an effort to inhibit emotional expression), which, especially in individuals high in the trait of emotional avoidance, paradoxically increases emotional distress instead of reducing, having been repeatedly associated with heightened physiological arousal, increased distress, and worsened outcomes in anxiety disorders such as PTSD, GAD, panic disorder, and social phobia (Amstadter, 2008). For years, Bob tried to suppress his anxiety. He would grit his teeth, breathe shallowly, and tell himself to “get over it.” However, research shows that suppression is a response-focused strategy that often backfires. While it may reduce outward expression, it typically increases physiological arousal and has little effect on internal distress (Gross & Levenson, 1997). For someone like Bob, already biologically sensitive, suppression can intensify the emotional response, leading to a vicious cycle of avoidance and anxiety (Campbell-Sills et al., 2006a).

However, in contrast to suppression, reappraisal (deliberately changing how one interprets or thinks about a situation in order to modify its emotional impact.) has shown positive effects in decreasing anxiety symptoms, when combined with treatments such as exposure therapy, which is shown to decrease both emotional and physiological arousal, indicating its therapeutic potential (Amstadter, 2008). Existing treatments (especially DBT, ACT, and Barlow’s unified protocol) already incorporate emotion regulation principles by encouraging acceptance, reducing avoidance, and teaching adaptive response strategies. Skills like mindfulness, opposite-action, and reappraisal align well with evidence suggesting that changing one’s relationship with emotions is more effective than suppressing them (Amstadter, 2008).

How Did the Psychotherapy Help Bob?

Through therapy, Bob learned about more adaptive strategies, such as cognitive reappraisal, which involves changing how we think about an emotion-triggering situation (Ochsner et al., 2004). For example, instead of interpreting a colleague’s silence as rejection, Bob began to consider alternative explanations: maybe they were distracted, tired, or just having a bad day. This shift in meaning helped reduce Bob’s distress and encouraged him to stay present instead of retreating into self-blame

Acceptance was another breakthrough for Bob. Rather than fighting his anxiety, he practised allowing it to be there, acknowledging it, breathing through it, and choosing not to run from it. This aligns with evidence showing that acceptance-based strategies are associated with reduced physiological arousal and greater emotional recovery (Eifert & Heffner, 2003).

What Bob Learned and What We Can Learn Too

Through therapy, Bob developed greater emotional clarity and regulation skills over time. He learned to name his emotions more accurately, moving from “I feel bad” to “I feel nervous about disappointing others.” He began practising mindfulness and compassion-based strategies, gradually replacing his old habits of worry and suppression.

He also learned to distinguish between emotional and physical discomfort. Through guided self-reflection, Bob realised that his tight chest and shaky hands were bodily responses that did not always signal danger. Instead, they were part of his body’s emotional alarm system. Labelling them as such allowed him to reframe them and respond more calmly (Lieberman et al., 2011).

Bob’s story illustrates that effective emotion regulation does not mean avoiding feeling. Instead, it means learning how to engage with them skilfully. This is not always easy, especially for those with underlying vulnerabilities. But with support, knowledge, and practice, change is possible.

Critical Reflections

Research consistently shows that how we respond to our emotions plays a big role in our mental health. Strategies like avoiding how we feel, bottling up emotions, or ruminating (replaying negative thoughts over and over) are strongly linked to anxiety, depression, and other mental health concerns (Aldao, Nolen-Hoeksema, & Schweizer, 2010). Thinking about my own lived experience with minority stress and how I coped with it for years, I can relate to these arguments, and they make a lot of sense to me and resonate with my own experience of emotional difficulties.

On the other hand, strategies such as reframing a difficult situation (known as “cognitive reappraisal”) or learning to accept emotions without judgment (as in mindfulness) are generally considered healthier ways to cope (Campbell-Sills et al., 2006a; Eifert & Heffner, 2003).

Interestingly, even when people feel better emotionally, their body’s stress system doesn’t always calm down. For example, people with Generalised Anxiety Disorder (GAD) might still show high stress in their heart rate even if they think they’re doing a good job regulating their emotions (Aldao & Mennin, 2012). This suggests that emotional healing encompasses both our thoughts and our body. And here again, my own experience in therapy has demonstrated to me that challenging a maladaptive thought does not always result in change in how I feel about myself, about other people and life. Thus, therapy needed to be more than just changing our cognitive patterns. I wanted to change my emotional experience of life.

While there is agreement on the importance of emotional regulation, studies also highlight that no single strategy works for everyone in every situation. For example, reappraisal helps many people reduce distress, but some studies suggest that people with anxiety or panic disorders may struggle to implement reappraisal work effectively (Ball et al., 2012; Goldin et al., 2009).

In contrast, acceptance-based approaches, where people mindfully allow uncomfortable emotions without trying to change them, tend to reliably lower avoidance and distress (Eifert & Heffner, 2003).

Even something as simple as naming a feeling (called “affect labelling”) can reduce the intensity of an emotional reaction. However, many people do not realise how helpful this strategy is (Lieberman et al., 2011).

These differences suggest that emotion regulation is not a one-size-fits-all approach; it depends on the individual, their emotional habits, and the specific context.

So, what does this all mean when you are working with a counsellor or therapist?

First, becoming more aware of how you usually respond to emotions is important. If you often avoid or suppress your feelings, therapy might start by helping you notice those patterns and gently practice alternatives. Suppression, for instance, has been shown to reduce emotional recovery and increase physical stress responses, especially for those with anxiety or mood disorders (Campbell-Sills et al., 2006a).

Therapists might then teach reappraisal or mindfulness strategies that help you feel more in control. However, the key is flexibility, which means choosing the right strategy at the right time. Some researchers argue that being able to switch between strategies depending on the situation may be more important than using any one technique perfectly (Aldao et al., 2010).

Also, the “triple vulnerability” model reminds us that anxiety disorders often arise from a mix of biological sensitivity, negative beliefs about emotions, and specific life experiences that shape our fears (Barlow, 2002). So, therapy must address all of these levels, not just the symptoms.

From my perspective, therapy and recovery are also about more than just helping individuals cope with mental health symptoms, but also helping individuals gradually reprocess implicit memories and, through reparative experiences, gradually challenge maladaptive schemas (or emotional scars) that often shape our emotional experiences of the present and our coping styles (behaviours).

Questions to Help You Reflect on Your Emotional Health

Do you, like Bob, tend to suppress or avoid uncomfortable emotions? What happens when you do?

When you are upset, do you try to ignore or push away the feeling? Or can you acknowledge and sit with it, even if it is uncomfortable?

How can you start experimenting with more adaptive strategies, such as reframing your thoughts or simply accepting your emotions with curiosity and openness?

Have you tried naming your emotions (e.g., “I feel sad” or “I am frustrated”) out loud or in writing? What did you notice after doing this?

Have you ever noticed that your body (heart rate, tension, stomach) stays activated even after you think you have “calmed down”? What might that be telling you?

What beliefs do you hold about your emotions? Are they “dangerous” or “shameful”, or just signals your body is giving you?

Do you tend to ruminate, repeatedly going over a problem in your mind? What healthier alternatives could you try, like acceptance or reappraisal?

How flexible are you when it comes to handling emotions? Do you always use the same strategy, or can you adapt it based on the situation’s needs?

What small step could you take today to treat your emotions more compassionately?

By reflecting on these questions, you can begin to notice your emotional habits and gradually develop more effective ways of coping with distress. Counselling offers a space to explore these strategies in depth and learn which ones work best for you.

 Final Thoughts

Bob’s journey reminds us that emotional suffering is not a sign of weakness. Instead, it is often the result of a complex interaction between biology, learning, and social context. However, it also shows that healing is possible when we stop fighting our emotions and instead learn to work with them.

Whether you are navigating anxiety, depression, or just the everyday waves of human feeling, your emotions are not enemies. They are messengers.

Moreover, with the right support, you can learn to listen and respond with wisdom!

References

1. Aldao, A., & Mennin, D. S. (2012). Paradoxical cardiovascular effects of implementing adaptive emotion regulation strategies in generalised anxiety disorder. Behaviour Research and Therapy, 50(3), 122–130.
2. Aldao, A., & Nolen-Hoeksema, S. (2010). Specificity of cognitive emotion regulation strategies: A transdiagnostic examination. Behaviour Research and Therapy, 48(10), 974–983.
3. Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237.
4. Amstadter A. Emotion regulation and anxiety disorders. J Anxiety Disord. 2008;22(2):211-21. doi: 10.1016/j.janxdis.2007.02.004. Epub 2007 Feb 23. PMID: 17349775; PMCID: PMC2736046
5. Ball, T. M., Ramsawh, H. J., Campbell-Sills, L., Paulus, M. P., & Stein, M. B. (2012). Prefrontal dysfunction during emotion regulation in generalised anxiety and panic disorder. Psychological Medicine, 43(7), 1475–1486.
6. Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic(2nd ed.). Guilford Press.
7. Campbell-Sills, L., Barlow, D. H., Brown, T. A., & Hofmann, S. G. (2006a). Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorders. Behaviour Research and Therapy, 44(9), 1251–1263.
8. Campbell-Sills, L., Ellard, K. K., & Barlow, D. H. (2014). Emotion regulation in anxiety disorders. In J. J. Gross (Ed.), Handbook of emotion regulation (2nd ed., pp. 393–412). Guilford Press.
9. Eifert, G. H., & Heffner, M. (2003). The effects of acceptance versus control contexts on avoidance of panic-related symptoms. Journal of Behaviour Therapy and Experimental Psychiatry, 34(3–4), 293–312.
10. Goldin, P. R., Manber-Ball, T., Werner, K., Heimberg, R., & Gross, J. J. (2009). Neural mechanisms of cognitive reappraisal of negative self-beliefs in social anxiety disorder. Biological Psychiatry, 66(12), 1091–1099.
11. Gross, J. J. (Ed.). (2014). Handbook of emotion regulation(2nd ed.). Guilford Press.
12. Gross, J. J., & Levenson, R. W. (1997). Hiding feelings: the acute effects of inhibiting negative and positive emotion. Journal of Abnormal Psychology, 106(1), 95.
13. Lieberman, M. D., Inagaki, T. K., Tabibnia, G., & Crockett, M. J. (2011). Subjective responses to emotional stimuli during labelling, reappraisal, and distraction. Emotion, 11(3), 468–480.
14. Ochsner, K. N., Ray, R. D., Cooper, J. C., Robertson, E. R., Chopra, S., Gabrieli, J. D., et al. (2004). For better or for worse: Neural systems supporting the cognitive down- and up-regulation of negative emotion. NeuroImage, 23, 483–499.
15. Troy, A. S., Wilhelm, F. H., Shallcross, A. J., & Mauss, I. B. (2010). Seeing the silver lining: Cognitive reappraisal ability moderates the relationship between stress and depressive symptoms. Emotion, 10(6), 783–795.

 

Published by:

Eric Rangel Oliveira
Accredited Mental Health Social Worker
Founder of ERTC – Eric Rangel Therapy & Consulting